Being stalked can be paralyzingly frightening. Victims aren’t traumatized just once; they’re perpetually unsettled by attempts at contact and often begin to feel like there’s no safe place to go.

The Bureau of Justice Statistics reports that about three million people are stalked every year, most by people they know—often a former intimate partner. As many as 10% of stalking victims fear for their lives, and all victims face massive disruptions to their routines. While stalking, like domestic violence, has been around for generations, it has been only in recent years that the issue has been taken seriously, and many victims may be hesitant to seek help.

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What Is Stalking?

At its core, stalking consists of repeated attempts to gain control over or terrorize someone. Stalking exists on a continuum. On the lower end, it might involve repeated phone calls, letters, or email contacts. In its more extreme manifestations, however, stalking might involve repeatedly going to a person’s house, making threats against a person, harming pets, stealing possessions, or interfering with a person’s relationships with friends, family, or coworkers. Stalkers may alternate between patterns of domestic violence and stalking.

Each state establishes its own legal criteria for stalking. Laws generally require multiple unwanted contacts and mandate that a victim fear for his or her safety. A coworker who comes back to see a person at his or her office daily, for example, would not be stalking, and a secret admirer who sends flowers once per week is not necessarily a stalker. Repeated contacts rise to the level of stalking when they’re designed to gain power over a person and cause emotional terror.

Why Do People Stalk?

Stalkers often emphasize that they “love” their victims and occasionally say they stalk to keep others safe. For example, an abusive ex-husband might say he stalks his ex-wife to ensure she’s properly caring for their children. Psychologically, however, stalking is a crime of control. Stalkers see their victims as possessions who are rightfully theirs, and stalking behavior is frequently activated by a breakup or an ex-partner’s new relationship.

Some mental health issues can lead to stalking. People with personality issues such as a borderline personality diagnosis may have trouble letting go of relationships and sometimes use manipulative tactics to control people. Erotomania is a delusion in which a person believes that another person—often a celebrity—is in love with him or her, and this can lead to stalking. However, not all stalkers have mental health conditions, and the overwhelming majority are men. Cultural and gender norms may contribute to stalking behavior.

What Can Victims Do to Get Help?

If you’re being stalked, don’t make excuses for the stalker or tell yourself you are overreacting. Tell a friend or family member what’s happening so you have a support person and a witness. If you are in immediate danger or are being followed, dial 911. There’s no price for overreacting, but underreacting to stalking can, in extreme cases, be fatal. Other things you can do to remain safe:

• Change your routine frequently so that it is more difficult for your stalker to find you.
• Instruct friends, family, and employers not to give out information about you without your express permission.
• Keep a log of every incident so you have evidence if you need to press charges.
• Seek a restraining order against the stalker, and call the police immediately if he or she violates the order.

References:

1. Help for victims. (n.d.). Stalking Resource Center. Retrieved from http://www.victimsofcrime.org/our-programs/stalking-resource-center/help-for-victims
2. King, M. W., & Sivak, A. (n.d.). Stalking: New studies shed light on a crime that terrorizes its victims. National Crime Prevention Council. Retrieved from http://www.ncpc.org/programs/catalyst-newsletter/catalyst-newsletter-2009/volume-30-number-11/stalking-a-new-study-sheds-light-on-a-crime-that-repeatedly-terrorizes-its-victims
3. Stalking. (n.d.). National Institute of Justice. Retrieved from http://www.nij.gov/topics/crime/stalking/
4. Stalking. (n.d.). USDOJ: Office on Violence Against Women: Crimes of Focus: Stalking. Retrieved from http://www.ovw.usdoj.gov/aboutstalking.htm

It’s a classic dynamic in nearly every relationship: One partner tends to be the more vocal, outwardly emotional communicator, while the other partner is stoic, bottled-up, and emotionally reserved. Sometimes, one partner can be both. When the communicator tries to get the bottle to open up, the result can be a tug of war that ends in criticism and distancing. In a recent article, licensed clinical social worker Terry Gaspard describes why the “pursuer-distancer” pattern can be lethal to your marriage. Gaspard says that even though the pursuer partners, usually women, have nothing but good intentions when they try to coerce their spouses to crack open their emotional vaults, they approach it the wrong way.

Harassing and nagging a reserved person to communicate will usually cause that person to close up more tightly. They can become avoidant, angry, defensive, and even hostile. The nagging partner will then escalate the nagging, maybe throwing in a little criticism as a negative motivator, all with the goal of creating a more intimate union with their spouse. Relationship expert Dr. John Gottman also warns against pushing your relationship into this downward spiral. He believes that gender differences are at the core of how partners communicate. He suggests that if communication issues are developing in a relationship, the couple should examine how they are addressing those issues before they find themselves in the pursuer-distancer­ vortex.

Gaspard notes that our culture is partly responsible for perpetuating this destructive dance. “The irony of the pursuer-distancer pattern is that it’s reinforced by popular self-help books and websites to save your marriage,” said Gaspard. Even therapists encourage their clients to develop healthy communication strategies. But without proper guidance, couples can enter into a dialogue without boundaries that can quickly take on a life of its own. Gaspard suggests that couples remain open with each other and think of communicating honestly as a way to share information with each other. Learning more about your partner’s feelings should be a pleasure, not a chore.

Reference:
Gaspard, Terry. (2013). How the pursuer-distancer pattern can destroy your marriage. (n.d.): n. pag. Huffington Post. Web. http://www.huffingtonpost.com/terry-gaspard-msw-licsw/how-the-pursuerdistancer-_b_2856533.html

We all engage in manipulation from time to time. When your boss asks you what you thought of his or her terrible presentation and you render lavish praise, you’re concealing your real feelings in an attempt to elicit the reaction you want from someone in power. But in close interpersonal relationships, manipulation can take on a much darker hue, leaving its targets never quite knowing where they stand.

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The very nature of manipulation makes it challenging to know when you’re being manipulated. Manipulators attempt to conceal their motives and feelings, and their targets—who often struggle to sustain an honest, open, and manipulation-free relationship—may have to do some detective work to determine whether they’re being played.

What Is Manipulation?
Manipulation is the process of trying to change another person’s feelings, beliefs, or behaviors through indirect tactics. Rather than asking for what they want, manipulative people tend to use deception, coercion, even threats to get their needs met.

Manipulation is associated with a number of mental health conditions, including borderline personality disorder, passive-aggressive personality disorder, addiction, antisocial personality disorder, and narcissism. Not all manipulative people have mental health issues, but when manipulation becomes a primary style of interaction, it can indicate an underlying psychological issue.

Tactics Manipulators Use
If you’re concerned that you’re being manipulated, examine the tactics the other person is using. If you find yourself caught up in a web of deception and unclear motives, it could be manipulation.

Some common tactics manipulators use include lying, withholding information, denying feelings, playing the victim, blaming the victim, minimizing others’ feelings, pretending to be confused or ignorant, guilt, shame, and pretending that his or her tactics are intended to serve a higher calling such as God or a political cause. Manipulators also frequently use gaslighting—the process of provoking someone into an extreme or angry reaction, then blaming the other person for his or her reaction.

While anyone can be manipulated, expert manipulators tend to target people with and take advantage of certain personality traits. These traits include:

• The desire to be liked or to please; these people are more likely to take extraordinary measures to gain favor
• Low self-esteem
• Dependency; people who tend to be dependent upon others will be more easily swayed by threats to withdraw love or support
• Naiveté or ignorance
• Loneliness
• Impulsivity, greed, and materialism
• Low assertiveness
• Fear of anger, sadness, and other negative emotions—either in oneself or from the manipulator

Why People Manipulate
For some people, manipulation may be an inadvertent strategy for dealing with a cutthroat world in which discussing feelings is often taboo. Manipulation is part of the normal range of behavioral tactics, and most people engage in manipulative strategies from time to time. People whose primary style of interaction is manipulation, however, tend to share some traits in common. These include:

• A need for control or power over others
• A need to raise their own self-esteem
• Fear of abandonment
• Feelings of worthlessness, helplessness, or hopelessness
• A willingness to prioritize their own feelings and desires over the needs and well-being of others

How to Handle a Manipulator
Many of us are highly aware when we’re being manipulated, but are still left unsure of what to do. Because manipulators often play the victim, some victims of manipulation might excuse their behavior or insist that the manipulator doesn’t really know what he or she is doing. Manipulators thrive on hiding their motives, so it can be challenging to get them to admit their true intentions, and many people will refuse to do so even under pressure. Instead, try the following tactics:

• Avoid allowing yourself to be shamed or guilted into doing something.
• When a manipulator makes a covert threat, ask him or her about the threat.
• Ask the manipulative person if he or she can tell you directly what he or she wants.
• Avoid sharing how the manipulation makes you feel, as these feelings can later be used as a tactic by the manipulator.
• Be direct, clear, and honest, and refuse to participate in the escalating game of manipulation.

References:

1. Psychological harassment and psychological manipulation. (n.d.). Psychological Harassment Information Association. Retrieved from http://www.psychologicalharassment.com/psychological_manipulation.htm
2. Simon, G. K. (n.d.). Dealing with manipulative people. RickRoss.com. Retrieved from http://www.rickross.com/reference/brainwashing/brainwashing11.html
3. Spotting emotional manipulation. (n.d.). Cassiopaea. Retrieved from http://www.cassiopaea.com/cassiopaea/emotional_manipulation.htm

One of the aspects of existential psychotherapy that I most value is the idea of personal responsibility. On one hand, we humans are free to live our lives the way we choose (within reason), while on the other, we are responsible for the choices we make. Freedom and responsibility go hand in hand, whether we like it or not.

Often, clients who enter psychotherapy have complaints about their lives, including their marriages, children, work environments, and many other interpersonal situations. Just as often, the clients are steadily looking outward at other people they deem responsible for the trouble. It is the spouse who is selfish, the children who just won’t listen, the unreasonable boss and the inconsiderate friends who drove the person to seek therapy. It is less often that a client comes in with a strong sense of personal responsibility and willingness to change in the beginning stages of therapy.

That is one of the challenges therapists face: how to help the client assume responsibility for his or her life without shaming or blaming. Without the clients taking on personal responsibility, no change can ever really happen because, as we all know, we can change and improve only ourselves. When faced with this challenge, I like to ask my client, “In all of the bad relationships, failed communications, and frustrating encounters in your life, what is the one common denominator?” That question allows the client to begin focusing on his or her role in whatever situation he or she is facing. Even if his or her role is as little as 1% of the issue, that 1% is where we start working. That 1% is where the change begins, and generally, the acceptance of responsibility of that small amount is what leads the client to being able to recognize other ways of being that may cause problems in his or her life.

The ability to take responsibility for one’s life is one of the greatest gifts we can offer ourselves and our clients. Although the weight of responsibility may seem heavy at times, it carries within in the seeds of freedom. When a person assumes responsibility for himself or herself, the person becomes empowered to be the person he or she chooses to be. Holocaust survivor and psychiatrist Viktor Frankl reminded us that the “last of the great human freedoms is to choose how to behave in any given circumstance.” Indeed, we have complete authorship over our attitudes, interactions, and responses.

Philosopher Jean-Paul Sartre states that to be responsible is to be the “uncontested author of an event or thing” and means that each individual, alone, is responsible for the creation of his or her life, including “self, destiny, life predicaments, feelings, and if such be the case, one’s own suffering” (Yalom, 1980). Becoming the author of one’s own life may start with something as simple as taking ownership for the 1% that is you, but will likely lead to a much deeper sense of ownership and freedom in one’s entire life. Therapy, done well, will assist participants in grasping a greater sense of self by way of freedom and responsibility.

Ask any armchair psychologist whether men or women are more sexual, and you’ll likely get an absolute proclamation that men are more visual, think about sex more often, and have more partners. These “facts” play into cultural mythology, that ties manhood to sexuality, and treats women as the fairer, less sexual sex. But research is increasingly showing that the things we all think we know about men and sex just aren’t true.

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Thinking About Sex

Many of us have heard the claim that men think about sex every seven seconds or every 15 seconds. But this statistic may be little more than a myth. A 2011 study found that men think about sex, on average, only 18 times a day—several thousand times less frequently than popular statistics claim. In fact, men think about sex only slightly more than they think about sleep, which crosses their mind 11 times a day, and as frequently as food, which also makes an appearance in their thoughts 18 times a day. But, according to the study, men still tend to think about sex more frequently than women. The women in the study thought about sex about 10 times a day, with individual numbers ranging from zero to 140 times daily. Individual men, by contrast, thought about sex between zero and 388 times each day.

Number of Sexual Partners

Men tend to claim more sexual partners than women, but upon careful examination, statistics on the lifetime average number of partners fall apart. Unless more men than women are gay or are having sex with a few of the same very sexually active women who aren’t represented in surveys, the averages for men and women can’t differ so dramatically. Several studies have shown that men are more likely to inflate their number of partners, while women are more likely to shave a few off the top.

Desire for Adventure

One famous study asked men and women if they’d be willing to sleep with an attractive stranger. A large portion of men said yes, while few of the women did. This study is often used to support the idea that men crave multiple sexual partners or new sexual experiences. But studies that ask men their desires don’t measure actual behavior. Men may say that they’re willing to sleep with an attractive stranger simply because this is the cultural expectation. Women may be hesitant to say that they’d have sex with a stranger because they don’t want to be perceived as promiscuous.

Are Men More Visual?

We’ve all heard that men are more visual than women, and this is used as justification for everything from looking at porn to ogling strangers. While most research does show that men are more visually stimulated than women, the interpretation of this data is much more complicated than it seems. One 2008 study, for example, emphasizes that sociological factors play a strong role in men’s visual stimulation. Men are taught from an early age to emphasize physical appearance, and the same study found that men tend to be more aroused by contexts in which they can objectify another person—a tendency that is probably learned.

Sex and Masculinity

Myths about men’s sexuality tend to stick around because they make sense in light of social roles and gender ideology. Although women are becoming increasingly sexually assertive, sexuality in women is still less acceptable than men, and women are often taught to feel some shame about sex; this can affect what they report to researchers and whether they share sexual thoughts. Sex-based myths can make women feel that sexual feelings are deviant and abnormal, and can support puritanical ideas about women and sex. But men are also harmed. Men who don’t meet masculine ideals by being hypersexual or craving multiple partners can feel less manly, while men who want a healthy sexual relationship with a single partner may feel pressure to engage in promiscuous or objectifying behavior.

References:

1. Jordan-Young, R. M. (2010). Brain storm: The flaws in the science of sex differences. Cambridge, MA: Harvard University Press.
2. Kolata, G. (2007, August 12). The myth, the math, the sex. The New York Times. Retrieved from http://www.nytimes.com/2007/08/12/weekinreview/12kolata.html
3. Men more willing to have sex with stranger than females: Study. (2011, September 04). Indian Express. Retrieved from http://www.indianexpress.com/news/men-more-willing-to-have-sex-with-stranger-than-females-study/841459
4. Men think about sex just 19 times a day – nearly as much as food. (2011, November 29). The Telegraph. Retrieved from www.telegraph.co.uk/health/healthnews/8924988/Men-think-about-sex-just-19-times-a-day-nearly-as-much-as-food.html
5. Rupp, H. A., & Wallen, K. (2008). Sex Differences in Response to Visual Sexual Stimuli: A Review. Archives of Sexual Behavior, 37(2), 206-218. doi: 10.1007/s10508-007-9217-9

Hypnosis has long been fodder for television shows and stand-up acts, and most people are familiar with hypnotists who claim to be able to make anyone do anything while under hypnosis. But hypnosis is no longer just a sideshow performance, and an increasing number of people are turning to hypnosis to quit smoking, get over depression and anxiety, lose weight, and forget about phobias.

Hypnosis is still controversial within mental health, partially because it’s often part of a comedy act and not real treatment and partially because some hypnotherapists have induced false memories under regression-based hypnotherapy.

What Is It?
Hypnosis isn’t a magic trick. It’s an altered state of consciousness that hypnotists induce via the power of suggestion. Hypnotists may use relaxation techniques, key words, guided imagery, or some combination of these to help clients slowly relax. Then, while under hypnosis, hypnotists make suggestions about changes in behavior.

The idea behind hypnosis is that, even when the conscious mind wants to do something, the unconscious mind might not fully accept this change. Hypnotists claim that, under the right conditions, they can subtly alter the effects the unconscious mind has on the conscious mind and help bring about behavioral changes. Some hypnotists use hypnosis to help gradually alter a client’s perceptions. A person struggling with pain, for example, might undergo hypnosis to help him or her see the pain as pressure. An increasing number of women are even using hypnosis to help cope with the pain of childbirth.

Does It Work?
You can’t be hypnotized to do something that is outside of your moral compass or that you don’t really want to do. People who try to quit gambling or spending through hypnosis will likely not see results if they’re quitting only because of family pressure. Hypnosis can’t change the way you think; it simply makes it easier to follow through with behavioral changes. Hypnosis can also bring about a state of relaxation, and some hypnotherapists teach their clients how to self-hypnotize under stressful conditions. For people with anxiety issues, severe stress, or depression, this can help ease the symptoms.

But hypnosis is not a panacea, and is most effective when it’s used in conjunction with therapy and lifestyle changes. Particularly for long-term, chronic problems, it may take several hypnosis sessions to see results. Some people don’t see any results at all; because hypnosis thrives on suggestibility, if you’re not particularly suggestible it probably won’t work.

Choosing a Hypnotist
If you’re thinking about trying hypnotherapy, get a recommendation from your therapist. The American Society of Clinical Hypnosis also maintains a directory of qualified hypnotists with a clinical background. Make sure you know how long your hypnotist has been practicing and what methods he or she uses. The messages you hear under hypnosis should not come as a surprise, and your hypnotist should discuss the specific tools he or she is going to use before hypnotizing you.

Regression-based hypnosis, which is used to recover repressed memories, can be dangerous. Because people are more suggestible under hypnosis, the hypnotist can inadvertently fabricate memories that didn’t actually occur. Particularly if these memories are traumatic, this can lead to additional mental health issues. People with a history of psychosis should not undergo hypnosis without first taking to their doctors, because hypnosis increases their risk of a psychotic episode.

References:

1. About the society. (n.d.). American Society of Clinical Hypnosis. Retrieved from http://www.asch.net/
2. Beattie-Moss, M. (n.d.). Does hypnosis work? Research Penn State. Retrieved from http://www.rps.psu.edu/probing/hypnosis.html
3. Mental health and hypnosis. (n.d.). WebMD. Retrieved from http://www.webmd.com/anxiety-panic/guide/mental-health-hypnotherapy
4. Portenoy, R. (2008, August 18). How does hypnosis work, can anyone be hypnotized, and when is it used? ABC News. Retrieved from http://abcnews.go.com/Health/TreatingPain/story?id=4047906

A few months ago, I wrote a piece about “good enough” parenting that seemed to strike a chord for many readers. Some challenged the idea that “good enough” could lead to complacency and short-change our children, but most expressed an appreciation for the self-acceptance inherent in that model. This month, at the risk of stirring up even more debate, I want to talk again about an approach to parenting.

After the birth of my son, I realized that if I ever wanted to take a shower again, I was going to have to let him cry it out for a time. This was very hard, but it was an important first step in my parenting journey that led me to embrace the art of benign neglect. It soon became clear to me that I would not physically be able to attend to my child’s every need every moment of the day. He would have to wait sometimes. He would have to entertain himself sometimes. He would have to delay gratification. This wasn’t a conscious parenting choice; it was just our reality. As it turns out, it was a pretty good thing.

Once my post-childbirth head started to clear, I remembered some words of wisdom from one of my favorite grad school professors. She opened the year by making the bold statement, “Our kids don’t suffer enough. They should suffer more. Thank you.” This was my introduction to the woman who led courses in achievement motivation and social and moral development. I was struck, even intrigued, by her words. As I followed her courses, I began to get what she meant. It was not, however, until I became a parent that I truly understood the implications, and challenges, of this concept.

What my professor was talking about was not abject, crushing, demoralizing suffering, but a more tempered form of discomfort and struggle. She was not advocating throwing our kids into the deep end of life and letting them sink or swim. What she was talking about was allowing them to face adversity while they still had a safety net, letting them stumble over little obstacles as practice runs at life’s larger challenges. Noted psychologist Lev Vygotsky talked about the concept of scaffolding—a way of providing appropriate support to children to allow them to stretch beyond their current abilities. As parents practicing the art of benign neglect, that’s what we try to do. If we do everything for our kids, if we smooth out every bump in the road, if we do everything in our power to remove pain, challenge, and discomfort from their young lives, we deny them the opportunity to learn, to grow, and to develop the coping skills they will need as they become independent adults.

When I think about the skills I want my son to develop, I want him to be secure. I want him to be confident in his own abilities. I want him to struggle through things, work them out on his own, ask for help when needed, and bounce back when things go wrong. I want him to be determined and resilient. In order to do all of this, sometimes I need to do nothing. I need to give him the chance to fail. I need to let him fall down, but be there to pick him up. This is what separates benign neglect from just plain neglect. I need to know where he is. I need to know what he is doing. I need to know that I’ve put the sharp knives out of his reach. It means, though, that sometimes I need to not intervene even when I so very much want to.

I see this in action when we are on play dates with friends. No parent wants his or her child to be pushing other kids or to be the kid being pushed around. Those practiced in the art of benign neglect will watch to see how events unfold. Do the kids sort themselves out when they scuffle? Are things escalating? Is anyone in danger of getting seriously hurt? Most of the time, the kids work things out on their own, learning valuable lessons and negotiation skills in the process. Sometimes, adult intervention just makes things worse. Other times, adult intervention is exactly what is needed to prevent full-scale descent into a Lord of the Flies scenario. When well-intentioned parents are ever-present, however, and intervene at the first hint of discord, our kids don’t get to learn how to work things out.

For the parents who are worried that if we don’t intervene our kids will learn poor strategies, hold those concerns for just a moment. Just because we do not intervene doesn’t mean we lose the teachable moment. Sometimes, our kids are more open to learning after an event rather than in the heat of the action. We can talk with them about their interactions. We can hear how they felt about it. We can talk about the consequences of the choices they made. We can teach them new strategies that they can try out next time. We can share wisdom and perspective, talk about our values and the way we want them to treat others, and we can encourage their independent growth. We can encourage them to think about why what they say and do is important, not because “we said so,” but for reasons that feel real to them. In short, we become resources for them and partners in their learning.

Practicing benign neglect as a parent is not about abdicating responsibility, ignoring limits, or letting go of all boundaries. On the contrary. It is about creating clear limits and boundaries, which all children need, yet allowing for enough freedom within those limits for true learning to occur. It is about watching and waiting and being intentional in the ways we intervene. It’s about allowing our children to feel some discomfort, letting them struggle, and helping them work through it. It is about loving them enough to let them experience the world in a way that lets them grow and learn, even when, with every fiber of our being, we want to shield and protect them from the bumps and bruises they will get along the way.

In a highly anticipated interview with Oprah Winfrey, famed cyclist Lance Armstrong has finally come clean about the allegations of doping that have haunted him for much of his unparalleled career. Armstrong, who in August 2012 was stripped of his record seven Tour de France victories and banned from competitive cycling due to mounting evidence of performance-enhancing drug use, is just one in a long line of athletes—most notably baseball players—who have either confessed to using performance enhancers or whose images have been tarnished by credible allegations of doping.

It’s no secret that many athletes will go to any length for a competitive edge, but performance-enhancing drugs carry numerous health risks, including baldness, impotence, infertility, addiction, psychiatric issues, hypertension, liver problems, and numerous other issues.

In a world where athletes who use performance-enhancing drugs always seem to get caught, often with disastrous consequences for their careers, what would compel an athlete to risk not only his or her health but livelihood as well?

Perfectionism and Pressure to Perform
Competitive sports can be cutthroat. Fans, coaches, and sponsors have high expectations for athletes, and hold in high regard records and never-been-done-before, seemingly superhuman feats. These expectations are frequently unrealistic, but can place considerable pressure on athletes. People in the upper echelons of athletics are often perfectionists to begin with; after all, it’s not easy to make it to the top. These perfectionist tendencies can make performance-enhancing drugs seem not only justified, but necessary.

Particularly when the competition uses performance-enhancing drugs, a dedicated athlete might feel like he or she has no choice. If the competition has an unfair advantage, taking drugs may seem less like cheating and more like leveling the playing field.

Peer Pressure
Particularly as more and more athletes admit to the use of performance-enhancing drugs, it can seem like sport is full of doping. Athletes may experience peer pressure from friends, teammates, and coaches, who may suggest that they can’t keep up with their competitors if they don’t use drugs. Peer pressure can also come in indirect ways. When athletes are criticized by peers, they might feel like their only hope for improvement can come in a vial or pill. Coaches, teammates, and even physicians or trainers may be complicit in doping.

Financial Issues
Not all athletes are wealthy. Particularly among Olympic athletes, financial gain often comes in the form of sponsorships, not from the sport or league. Many athletes spend years paying coaches, trainers, and gyms, and may get deep in debt covering the costs of developing into one of the best at what they do. Athletes are much more likely to get cushy sponsorship deals and contracts when they break records or win competitions. Particularly when an athlete knows or believes that other successful people in his or her field are using performance-enhancing drugs, they might seem like the most attractive or likely way to get out of debt and into financial security.

Secrecy
Although many athletes are regularly drug-tested, dopers try to stay one step ahead of the science. Many athletes have devised novel ways to avoid being caught, and in a high-stakes world, it’s easy to believe you can outsmart the testing mechanisms. Indeed, many athletes have managed to do just that for years, so the risk might seem worth it to an athlete under immense pressure.

References:

1. Oprah: Lance Armstrong confesses. (2013, January 16). ESPN. Retrieved from http://espn.go.com/sports/endurance/story/_/id/8845599/oprah-winfrey-confirms-lance-armstrong-admitted-doping
2. Performance-enhancing drugs: Know the risks. (2012, December 12). Mayo Clinic. Retrieved from http://www.mayoclinic.com/health/performance-enhancing-drugs/HQ01105
3. Shermer, M. (2008, March 31). The doping dilemma. Scientific American. Retrieved from http://www.scientificamerican.com/article.cfm?id=the-doping-dilemma
4. Shermer, M. (2009, September 07). Why athletes dope. The Huffington Post. Retrieved from http://www.huffingtonpost.com/michael-shermer/why-athletes-dope_b_278861.html

According to comScore, which measures Internet traffic, 66% of Internet-using men between the ages of 18 and 34 look at online pornography at least once a month. Does it really matter if you watch pornography? Does it really impact marriages and relationships? Two-thirds of divorce lawyers say the Internet has played a significant role in divorces within the past year, with excessive interest in online pornography contributing to more than half of such cases. That does not even speak to the impact pornography has on physical and emotional intimacy in relationships.

Consider these five reasons pornography can hurt your love relationship:

1. Men who view pornography can experience “sexual anorexia”! What? Indeed, the results of a study in Italy that surveyed 28,000 porn users seem to corroborate the notion that too much porn has a negative impact on sexual performance. Apparently, men become so accustomed to the unrealistic images they see in pornography that they can no longer get erections. Many men don’t realize their brain’s sensitivity is declining toward “normal” sex because web-based erotica delivers endless dopamine hits—making erection and climax possible where normal encounters would not. When they try to have actual intercourse and cannot, they understandably panic. The brain changes that cause porn-induced erectile dysfunction arise from actual, physical addiction processes (among them, numbing of the pleasure response of the brain).
2. With porn, partners are always willing and ready for sex! Where sexual drive varies in individuals, porn creates the unrealistic illusion that your partner should always be ready, willing, and able. Imagine the pressure this puts on your partner. It leaves no room for emotional connection, real-life circumstances, and the fun of pursuing each other in ways that are meaningful to each other rather than with only one objective in mind. If your partner has had a tough day at work, fought traffic, made dinner, taken care of the kids, done laundry, and prepared the family for the next day but then felt too tired for sex and consequently got replaced by porn, is this going to build intimacy or destroy it?
3. Porn creates scenarios that just aren’t real! Here are some conclusions from a study by the surgeon general: The values expressed in pornography clash with the family concept, and potentially undermine the traditional values that favor marriage, family, and children. Pornographic scripts dwell on sexual engagements of parties who have just met, who are in no way attached or committed to each other, and who will part shortly, never to meet again. Sexual gratification in pornography is not a function of emotional attachment, of kindness, of caring, and especially not of continuance of the relationship, as such continuance would translate into responsibilities, curtailments, and costs. Now what if I told you that study was conducted in 1986? Consider how much more widespread pornography is today with the Internet, social media, etc. Porn sets up couples and families to fail because as one becomes more immersed in the false “reality,” true reality suffers and is shamed.
4. Real-life partners can’t compete with embellished pornography! Porn creates an environment in which everyone is beautiful or handsome. Body parts are perfect, accentuated, and responsive in extreme satisfaction. How can anyone’s spouse or partner compete with that? If someone is indulging in hours of pornography, how can it not affect his or her reality when looking at a spouse or partner? The partner will begin to feel inadequate, judged, and compared, and might shut down or withdraw. This only leads to more disconnect on both parts and, for the one viewing porn, can start the path to even more sexual dysfunction.
5. It is not only the partner who can’t live up to the porn standards! So you view pornography, watch how “perfect” things are, how every encounter is desired and accepted, every act brings mutual satisfaction, and the performance never fails, never disappoints. How can anyone live up to that? The truth is, you can’t—and you are not supposed to. In a true relationship, you accept each other for who you are, you make it special for each other, and there is understanding and compassion, not fear and judgment. Pornography is NOT reality, and forcing oneself to watch unrealistic situations over and over and then expecting yourself to perform the same way is setting yourself and your partner up for disappointment.

This is the reality of the impact pornography has on your loved one and your love life. There is the argument that moderation is the key, but too many studies show that it typically does not stay at moderation—it escalates, requires more intensity to meet sexual gratification, begins to have a negative impact on sexual experience with your partner, and eventually causes a disconnect in relationships that is difficult to overcome.

Sure, it is easy to brush it off and say it won’t happen to you, but before coming to that conclusion, take an honest look at what pornography has already done in your life, in your partner’s life, in the area of hiding the habit, shame on you and your partner … if you want a truly honest response, have an open mind to what your partner thinks of your viewing of pornography. Based on real studies, real facts, real impacts on relationships, what are you going to do? It is never too late to get help through counseling, support groups, and accountability to begin the path of personal and relational healing.

The Diagnostic and Statistical Manual of Mental Disorders serves as the “bible” of mental health practitioners, who rely on it to match diagnostic criteria with behaviors. The American Psychiatric Association periodically examines trends in mental health conditions and recent scientific evidence to revamp the criteria. The latest edition, the DSM-5, is slated for release in May 2013, and the APA recently approved several changes.

Among the new diagnoses is excoriation, which is associated with chronic skin-picking. The issue is most common among women between the ages of 30 and 45. It’s classified as an impulse control disorder and is related to obsessive compulsion.

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What Is Excoriation?
Although excoriation disorder is the name of the new “official” diagnosis, the issue has been studied for years—sometimes called neurotic excoriation, compulsive skin-picking, dermatillomania, and psychogenic skin-picking. The issue was not included in previous editions of the DSM because it is believed to sometimes be a symptom of another issue.

Skin-picking is common among people with autism spectrum as well as obsessive compulsion. When it does not co-occur with another issue, however, it qualifies for its own diagnosis. Symptoms of the issue include compulsive skin-picking that leads to injuries or wounds as well as stress. Skin-picking is relatively common. Some people pick their skin to the point of bleeding or pain by popping pimples, picking at hangnails, or peeling scabs.

Controversy Surrounding Diagnosis
Whenever the APA adopts new diagnoses or symptoms, there is always some controversy, and excoriation is no exception. Although the diagnosis has received considerably less attention than some other changes, some mental health experts have expressed concern. Because excoriation often is a symptom of an underlying issue, a separate diagnosis might stigmatize people by giving them multiple diagnoses when only one is necessary.

Some clinicians have argued that excoriation does not meet the criteria for a mental health diagnosis and is more akin to a habit. By creating diagnostic criteria for a habit, the DSM might eventually have to include other habits. However, excoriation does sometimes occur on its own, and people with the condition can experience considerable distress, so the APA opted to include it.

How Excoriation Is Treated
When compulsive skin-picking occurs, it’s important to rule out a potential medical cause such as allergies or infection. Occasionally, skin conditions can superficially resemble symptoms of excoriation. Further, excoriation can cause dermatological problems, so patients frequently need dermatological treatment along with mental health treatment.

Antidepressants are the first line of treatment for excoriation. Opioid antagonist medications, which interfere with the body’s ability to respond to endorphins and opioids, also are sometimes effective. Because compulsive skin-picking often co-occurs with anxiety, anti-anxiety medications can be helpful.

Psychotherapy that helps people develop better approaches for dealing with anxiety, enables them to develop better impulse control, and helps patients cope with changes to appearance as a result of excoriation is also a typical part of treatment.

References:

1. American Psychological Association. APA concise dictionary of psychology. Washington, DC: American Psychological Association, 2009. Print.
2. Brauser, D. (2012, December 3). Experts react to DSM-5 Approval. Medscape Reference. Retrieved from http://www.medscape.com/viewarticle/775526
3. Colman, A. M. (2006). Oxford dictionary of psychology. New York, NY: Oxford University Press.
4. Neurotic excoriations. (2012, June 27). Medscape Reference. Retrieved from http://emedicine.medscape.com/article/1122042-overview
5. Neurotic excoriation. (n.d.). SkinPick. Retrieved from http://www.skinpick.com/neurotic-excoriation

Last month, we talked about how figuring out why someone is doing something is key to changing his or her behaviors. We learned that most behaviors are motivated by getting something, getting away from or stopping something, feeling good, or are simply automatic (a reflex, for example).

In order to change behaviors, we must learn about reinforcement, not merely the functions of the behaviors.

Case Example
Imagine this scene, one that is played out in countless grocery stores every day around the world. Picture, if you will, a harried mother trying to get the shopping for the house completed. She is tired and in a rush to get home. With her is her young son. In the checkout line, as Mom tries to load the groceries on the little conveyor belt, her child asks for a candy bar (located conveniently an arm’s reach away, at child eye level). Mom, being a kind and benevolent mom, says, “No, we’re going home and having dinner. You don’t need a candy bar right now.” Her son, being like most children of his age, doesn’t like this state of affairs. In response to the denial of sucrose refreshment, he starts wailing at the top of his lungs, “PLEEAAAASEE! I WANNA CANDY! I WANNA CANDY! I WANNA CANDY!”

Other store patrons stare at the impending debacle. Mom feels embarrassed and more than a little ticked off. She still has to get the groceries home, get them unpacked, and make dinner. Dealing with a tantrum is the last thing she wants to do. At first she tries to calmly explain to her child that dinner will be soon, but the child screams louder. Then she commands him to cease his tantrum. That works about as well as can be expected (not at all). Finally, Mom gives in and buys her little angel the candy bar, at which point he immediately ceases his caterwauling.

Can you name all the reinforcement that occurred in the above example? What do you think will happen next time Mom brings her son to the grocery store?

What Is Reinforcement?
The technical definition of reinforcement is anything that occurs after a behavior that increases the chances of that behavior occurring again. Simply put, when your child does something (a behavior) and you do something immediately afterward, if your child repeats the behavior, whatever you did was a reinforcer.

This idea is key to behavior change. We want to provide rich and powerful reinforcement for the behaviors we wish to see (start behaviors) and avoid reinforcement for the behaviors we do not wish to see (stop behaviors). This interaction is at the heart of everything we wish to accomplish.

Important points:

• Reinforcement occurs only if you see the behavior again. You might feel you are rewarding your child, but if the reward does not result in increased frequency, intensity, or other improvement in the behavior, then the reward is not reinforcing.
• Reinforcement can be anything. It doesn’t have to be pleasant, either. For example, a person who likes fighting might enjoy when he is in a fight and find getting hit or yelled at reinforcing.
• Reinforcement always increases behaviors. Anything that decreases the chances of seeing a behavior is called a punisher.

The bottom line? Reward your kids when they do what you want them to do and they will do those things more. If you simultaneously remove the rewards from the behaviors you want to see less of, you will see less of those behaviors.

Isn’t this just bribery, you may ask? Nope. There are some key differences between bribery and reinforcement. Bribery is typically something (often money) given to someone in advance of behavior. It is generally given to get a person to do something unethical or illegal. Reinforcement always occurs after a behavior, and we are not using it to get our children to do anything unethical or illegal (hopefully!).

You might also ask: Why should I be rewarding my kid for doing what he is supposed to do? Shouldn’t he just do it? In a perfect world, yes, your child would do what he or she is supposed to do. However, in the real world, children are compelled by the “drive-your-parents-nuts accord” to not always follow directions. If we, as parents, want to keep our sanity, it behooves us to use all the tools at our disposal to encourage and reward our children, and ultimately to teach them what to do and when to do it.

Types of Reinforcement

• Positive: This is the most common type. It is something that is added to the situation (money, candy, praise). Basically, if you give your child something because he did something good, that’s positive reinforcement. In the case example, the mother positively reinforced her child’s checkout-line tantrum behavior by buying him the candy.
• Negative: This not punishment. (That decreases behaviors.) It is the removal of something. In the case example, the child negatively reinforced his mother’s candy-buying behavior by ceasing his tantrum when she gave in and bought it.

Classes of Reinforcers

• Primary: These are typically those things that all people need—food, air, companionship, etc.—and are often tied to basic survival. These are good because almost everybody will respond to them. However, they suffer from the “too-much-of-a-good-thing” effect, also known as satiety. When you’ve had enough of something, it loses its reinforcing qualities.
• Secondary: These are learned reinforcers. Typically paired in some way with primary reinforcement, these can be anything. Money is perhaps one of the most prevalent secondary reinforcers in the world. It always amazes me what people will do for colored bits of paper.

Putting This Information to Use

Follow these simple steps:

1. Ask yourself: Is this a start behavior or a stop behavior? (Do you want to see this more or less?)
2. Ask yourself: What is the function of the behavior?
3. For stop behaviors, the answer to question No. 3 will tell you what you need to decrease or eliminate from the situation to make the behavior go away. Do that.
4. For start behaviors, the answer to question No. 3 will tell you what you need to do to get the person to do the behavior more (or better).

As with all things simple, there is a lot more to look at, but it ultimately comes down to these four points. (We will discuss more about reinforcement and how to set it up and deliver it in future articles.)

What’s the Best Reinforcer?
The best reinforcer is the one that works in a given situation. However, my preference is praise. I will cover praise in more detail in a future article, but here is why I like it as a reinforcer: Just about everybody responds to praise. The more you praise someone, the more he or she likes you. The more he or she likes you, the more he or she will respond to you. Praise is free. It takes up no space. People rarely get tired of it. It pairs well with every other kind of reinforcer (thus making the praise and the other reinforcer more effective). In your experiments with reinforcement, try adding a little praise to your efforts and see how it enhances things.

I hope this information helps make your day-to-day challenges less challenging. Please comment below, ask questions, or make suggestions. Let me know about creative ways you have found to reinforce your children (or anyone else, for that matter). Hang in there, parents!

To me, “vulnerable” is wonderful word. It means openness, freedom, and the opportunity to love and be loved. But for others, it is what they are trying to get away from: They feel that they are too vulnerable. In actuality, the opposite is true. They feel unsafe because they are too defended, too guarded. True vulnerability comes only with acceptance of self. And with that, fear drops away.

By becoming vulnerable to life, we discover its meaning. Not the meaning of life in an objective sense, but rather its meaning and purpose for each one of us, as individual souls. Whether that is the truth of a given moment, or an expanded sense of purpose and destiny in our professional or personal lives, we can discover it only if we learn to listen to our own hearts in an unguarded and open way.

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Our Own Vulnerability

To be happy and content in life, we must give in and learn to listen to ourselves deeply. We must accept our vulnerabilities, open ourselves to them, and embrace them! Why? Because only then do we feel the safety net that is always there; that mysterious presence that is beauty, love, kindness, and truth. When we don’t move into the mystery of vulnerability, it is like we are clinging to a tightrope after having fallen off, peering into the dark, afraid that there is no net. We find the net by letting go, by falling into the unknown.

This surrender does not have to be, as many think, a large display of emotion, because it is at its heart something internal, something private. Our closest, longest, and most intimate relationship is the one we have with ourselves. So while we might first experience vulnerability with someone else, it is at its heart something we must do with ourselves, by ourselves. It is not enough to be accepted by someone else: We must accept ourselves.

Allowing Others to Be Vulnerable

By becoming vulnerable to yourself, you move toward being vulnerable in your relationships and, just as importantly, being able to accept the vulnerability of those you love. This can be some of the hardest work we do: allowing the people we depend on to have their own vulnerabilities, their own weaknesses, their own struggles.

When vulnerability is not allowed in a relationship, it separates people, no matter how much they love each other. A person may love someone, but he or she may also want that person to be something he or she is not, or to just plain stop having the pain or struggle that he or she does. This dynamic can create a vicious cycle of resentment and frustration in one person, and a sense of confinement, judgment, and claustrophobia in the other.

Practice

Maybe this sounds simple to you, or perhaps complicated and confusing. It all begins with whatever moment you are in. And it takes baby steps. If you are interested in exploring more, note the time and do this five-step practice for the next five minutes:

1. Take three deep breaths. In through the nose, out through the mouth. Soften your shoulders, your forehead, your eyes.
2. Become vulnerable to everything happening in this moment. All the feelings, all the thoughts. Accept and allow everything. Soften toward every part of yourself. Breathe.
3. Soften all resistance to what is here. Feel the energy of your body, emotions, and mind. Feel whatever pain you may be having. Don’t label or think about it, just sense it fully. Don’t push anything away. Breathe.
4. Allow the waterfall that is the experience of each passing moment to wash over you. Just for this moment, accept fully and forgive yourself for all the failings and faults, all the regrets and mistakes that are marching through your mind. Let go of the fight and allow yourself to be just as you are right now. Breathe.
5. Now return to the top and continue the practice. Close your eyes as you are able, repeating the steps and continuing to soften and breathe.